Carotid Artery, Internal ; pathology ; Humans ; Oropharynx ; pathology ; Pharyngeal Diseases ; diagnosis

Ectopic internal carotid artery (ICA) is a very rare congenital variation. Unless the diagnosis is made before neck or tonsil surgery, massive hemorrhage and even death may result from injury to the vessel. Therefore, knowledge of the presence of ectopic ICAs may be important. We report two cases suffering from dysphagia associated with ectopic ICA manifesting itself as a pulsative protruding of the right lateral wall of the oropharynx.
Carotid Artery, Internal ; abnormalities ; Deglutition Disorders ; pathology ; Humans ; Oropharynx ; pathology

Adenoid cystic carcinoma usually occurs in the salivary glands of the head and neck. It is a malignant tumor with a high degree of malignancy, resistance to radiotherapy and chemotherapy and poor prognosis. The clinical course of adenoid cystic carcinoma is slow and easy to be misdiagnosed. The main diagnosis and treatment means are individualized and precise treatment under the multi-disciplinary consultation mode, that is, surgical treatment and radiotherapy and chemotherapy. Adenoid cystic carcinoma is prone to relapse and hematologic metastasis, and the traditional radiotherapy and chemotherapy based therapies have not achieved satisfactory efficacy in the past three decades. How to detect, diagnose and treat early is an urgent task faced by clinicians.
Humans ; Carcinoma, Adenoid Cystic/pathology* ; Neoplasm Recurrence, Local ; Neck/pathology* ; Oropharynx/pathology* ; Diagnostic Errors

Child ; Family ; Humans ; Neuroectodermal Tumors, Primitive/pathology* ; Neuroectodermal Tumors, Primitive, Peripheral/pathology* ; Oropharynx

Patient, 30-year-old, male,was admitted to our hospital because of discontinuously spit fresh blood without any inducing factors for three days. In the course, the patient suffered mild dry sensation of pharyngeal, poor spirit condition, fatigue, poor sleep, poor appetite and was with black stool 2 times. Physical examination: T36. 6°C, R 21/min, P98/min, BP135/90 mmHg (1 mmHg = 0.133 kPa). Bilateral tonsils were III hypertrophy and with scar shape surfaces. The left tonsil's surface had longitudinal small blood vessels markedly dilated. His oropharynx, laryngopharynx and laryngeal did not be find any obvious bleeding sites. Laboratory findings: WBC 13.82 x 10(9)/L, N 0.8084, L 0.1632, Hb 81.00 g/L, HCT 25.20; PT 9.60 s, APTT 25.50 s, TT 15.80 s, FIB 1.900 g/L. After 3 hours of admission,the patient spit out fresh blood again,checked the body to see:the left peri-tonsil with fresh blood and found a slowly bleeding site at the 1/3 junction of the middle lower part of left tonsil's rear surface, the size was about 0.5 cm x 0.6 cm. We finally diagnosed spontaneous tonsillar hemorrhage and successfully managed with low-temperature radiofrequency technology.
Adult ; Catheter Ablation ; Hemorrhage ; therapy ; Humans ; Hypertrophy ; Hypopharynx ; Larynx ; Male ; Oropharynx ; Palatine Tonsil ; pathology ; Temperature

OBJECTIVE: The aim of this study was to determine if snorers have a narrower oropharyngeal airway area because of fat infiltration, and an elevated body mass index. MATERIALS AND METHODS: Ten control subjects and 19 patients that snored were evaluated. We obtained 2-mm-thick axial CT scan images every 0.6 seconds during expiration and inspiration at the same level of the oropharynx. We selected the largest and the smallest oropharyngeal airway areas and found the differences. From the slice that had the smallest oropharyngeal airway area, the thickness of the parapharyngeal and subcutaneous fat was measured. The measurements from the left and right side were added together and single values for parapharyngeal and subcutaneous fat tissue thickness were then found. RESULTS: The conventional measure of body mass index was significantly higher in the snorers (p < 0.05). The difference in the smallest oropharyngeal airway area between snorers and the controls was statistically significant (p < 0.01). The average difference between the largest and the smallest oropharyngeal area in the control group and the snorer group was statistically significant (p < 0.05). There was no significant difference in the largest oropharyngeal airway area, the total subcutaneous fat width and the total parapharyngeal fat width between snorers and control subjects (p > 0.05). CONCLUSION: We concluded that the oropharyngeal fat deposition in snorers is not an important factor, and it does not predispose a person to the upper airway narrowing.
Adipose Tissue/pathology/*radiography ; Adult ; Body Mass Index ; Female ; Human ; Male ; Middle Aged ; Oropharynx/pathology/*radiography ; Snoring/pathology/*radiography ; *Tomography, Spiral Computed

OBJECTIVETo discuss the surgical methods and clinical effect of endoscopic transoropharyngeal approach to deal with the lesions of the ventral region of the craniocervical junction.

METHODSFrom August 2002 to November 2006, endoscopic transoropharyngeal approach was taken to deal with the lesions of the ventral region of the craniocervical junction, including 6 patients with chordoma, 5 patients with craniovertebral malformation, 3 patients with skull-base invagination combined with Chiari malformation, 2 patients with odontoid fracture . 0 degrees endoscope was used to deal with the lesions of middle and lower clivus, 30 degrees endoscope was used to deal with the lesions of craniovertebral malformation.

RESULTSFollow-up ranged from 2 to 48 months. Three patients with chordoma recurred. All patients with craniovertebral malformation recovered.

CONCLUSIONSEndoscopic transoropharyngeal approach is a new method to deal with the lesions of the ventral region of the craniocervical junction, and it has many advantages, such as direct approach, good exploration, micro-invasive, wide operation space, and good results.

Adolescent ; Adult ; Aged ; Cervical Vertebrae ; pathology ; Child ; Endoscopy ; methods ; Female ; Head ; Humans ; Male ; Middle Aged ; Neck ; Occipital Bone ; pathology ; Oropharynx ; pathology ; Skull Base ; surgery ; Young Adult

OBJECTIVETo investigate the upper airway structure of sleep-disordered breathing children.

METHODSSeventy three children with obstructive sleep apnea hypopnea syndrome (OSAHS), 53 children with primary snoring (PS) and 40 control subjects underwent pharyngeal magnetic resonance imaging (MRI). Upper airway structure images were analyzed and measured.

RESULTSThe cross-section area of the nasopharyngeal and palatopharyngeal airway in subjects with OSAHS and PS are smaller (P < 0.01) than that of the control group. The cross section area of OSAHS patients are smaller than that of PS subjects (P < 0.01). The above parameter of oropharyngeal airway in OSAHS patients is smaller than that of control group (P < 0.01), but no statistic difference compared with that of PS subjects. The cross-section area and length of the adenoid in OSAHS group are bigger and longer than that of PS group (P < 0.01) and bilateral tonsils are larger (P < 0.01); in OSAHS patients the cross-section area of the soft palate is larger and the length of the soft palate is longer (P < 0.01) than that of PS group, while this parameter of PS group is similar to that of the control group. And the maximum width of the soft palate, the cross-section area of bilateral fat pad, bilateral pterygoid and tongue are similar among OSAHS, PS and the control group. The skeletal measurement: the length of H-C2C3 in subjects with OSAHS is longer (P < 0.01); The angle(alpha) in OSAHS patients is smaller (P < 0.01) than that of other 2 groups. The angle (beta), the cross-section area of the mandible, the spine-clivus oblique, the length of the hard palate and the distance of the mandible are similar among the three groups.

CONCLUSIONSIn children with OSAHS or PS, the upper airway is restricted by both the adenoid and tonsils; however, the soft palate is also larger in OSAHS, adding further restriction. Otherwise, downward movement of the hyoid bone and decreasing of the angle (alpha) in OSAHS influence laryngopharynx airway. MRI is of clinical significance for evaluating OSAHS children's upper airway.

Case-Control Studies ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Magnetic Resonance Imaging ; Oropharynx ; pathology ; Palatine Tonsil ; pathology ; Pharynx ; pathology ; Respiratory System ; anatomy & histology ; Sleep Apnea, Obstructive ; pathology ; Snoring ; pathology

PURPOSE: We describe the epidemiological and clinical characteristics and the efficacy of a delayed initiation to therapy in an oropharyngeal tularemia outbreak in Duzce, Turkey. MATERIALS AND METHODS: Between March and June 2000, 22 patients with tularemia were diagnosed by microagglutination tests. RESULTS: Oropharyngeal and ulceroglandular forms of the disease were discovered. Most of the cases were oropharyngeal (19 cases). The most common symptoms were sore throat (95.4%) and fever (90.9%). Lymphadenopathy (95.4%) and pharyngeal hyperemia (81.8%) were usually observed signs. The lymphadenopathies were localized especially in the left cervical region (66.7%), a finding that has not been previously reported in the literature. The time between the onset of the symptoms and diagnosis was 40.7 +/- 22.8 (10 - 90) days. The patients were treated with streptomycin plus doxycycline and ciprofloxacin. The patients' recoveries took up to 120 days. CONCLUSION: This report describes the first outbreak of tularemia in northwest Turkey. Tularemia may occur in any region where appropriate epidemiological conditions are found and should be kept in mind for differential diagnosis in oropharyngeal symptoms. Late initiation of therapy may delay complete recovery. In this outbreak, cervical lymph nodes predominantly localized on the 1eft side were found, which had not been previously reported.
Adolescent ; Adult ; Aged ; Child ; Diagnosis, Differential ; Disease Outbreaks/*statistics & numerical data ; Female ; Humans ; Lymph Nodes/pathology ; Lymphatic Diseases/*microbiology/*pathology ; Male ; Middle Aged ; Oropharynx ; Tularemia/*epidemiology/*pathology ; Turkey/epidemiology ; Water ; Young Adult